With Accolade Pact, Humana Aims for Group-Segment Growth

March 25, 2019

Humana Inc. on March 15 said that it will team up with a Seattle-based company called Accolade to “create a differentiated healthcare and benefits experience for consumers” by combining the insurer’s capabilities with the startup’s data-driven member engagement platform.

But the move is more than just the latest insurer-tech solution collaboration — rather, Humana is signaling that it’s part of a play to capture more of the group- insurance market.

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Humana Inc. on March 15 said that it will team up with a Seattle-based company called Accolade to “create a differentiated healthcare and benefits experience for consumers” by combining the insurer’s capabilities with the startup’s data-driven member engagement platform.
But the move is more than just the latest insurer-tech solution collaboration — rather, Humana is signaling that it’s part of a play to capture more of the group- insurance market.

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CMS Nudges Uninterested States, Insurers on Interstate Sales

March 25, 2019

The notion of allowing individuals to purchase health insurance across state lines is nothing new. But the reality is that states want to retain regulatory authority over products sold within their borders, and health plans already sell in multiple states if it makes business sense to do so and if they have enough market clout to form provider networks. So, it was puzzling to some industry experts when CMS recently issued a request for information (RFI) on an issue that, as one put it, seems to be a non-starter solution in search of a problem.

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The notion of allowing individuals to purchase health insurance across state lines is nothing new. But the reality is that states want to retain regulatory authority over products sold within their borders, and health plans already sell in multiple states if it makes business sense to do so and if they have enough market clout to form provider networks. So, it was puzzling to some industry experts when CMS recently issued a request for information (RFI) on an issue that, as one put it, seems to be a non-starter solution in search of a problem.

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Exec Touts GuideWell’s ‘In Your Face’ Emergency Care Move

March 25, 2019

GuideWell Mutual Holding Corp., a Florida-based company that owns Florida Blue and other health plans alongside care delivery businesses, had a problem in the Orlando area that other insurers might recognize all too well. “We were having an admission rate through the emergency room in the central Florida hospitals that was exponentially higher than we were seeing anywhere else,” GuideWell President and CEO Patrick Geraghty said during a March 13 presentation at America’s Health Insurance Plans’ National Health Policy Conference.

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GuideWell Mutual Holding Corp., a Florida-based company that owns Florida Blue and other health plans alongside care delivery businesses, had a problem in the Orlando area that other insurers might recognize all too well. “We were having an admission rate through the emergency room in the central Florida hospitals that was exponentially higher than we were seeing anywhere else,” GuideWell President and CEO Patrick Geraghty said during a March 13 presentation at America’s Health Insurance Plans’ National Health Policy Conference.

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Colorado Soon Will Tighten Rules for Short-Term Plans

March 25, 2019

Starting April 1, payers who decide to sell short-term limited duration (STLD) health benefit plans in Colorado must offer products covering essential health benefits mandated by state law — such as preventive services, prescription drugs, hospitalization and maternity and newborn care. Short-term plans also won’t be able to deny applicants based on their health status: They must be guaranteed issue. The state’s added requirements are aimed at deterring competitors which might otherwise “come in and cannibalize the market,” one expert tells AIS Health.

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Starting April 1, payers who decide to sell short-term limited duration (STLD) health benefit plans in Colorado must offer products covering essential health benefits mandated by state law — such as preventive services, prescription drugs, hospitalization and maternity and newborn care. Short-term plans also won’t be able to deny applicants based on their health status: They must be guaranteed issue. The state’s added requirements are aimed at deterring competitors which might otherwise “come in and cannibalize the market,” one expert tells AIS Health.

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by Jinghong Chen Medicare and Medicaid are better than private insurance at containing per-beneficiary health spending growth, according to a recent analysis published by the Urban Institute. The report says that from 2006 to 2017, per-enrollee spending grew 2.4% in Medicare, 1.6% in Medicaid and 4.4% in private plans annually. While the overall spending growth […]

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by Jinghong Chen Medicare and Medicaid are better than private insurance at containing per-beneficiary health spending growth, according to a recent analysis published by the Urban Institute. The report says that from 2006 to 2017, per-enrollee spending grew 2.4% in Medicare, 1.6% in Medicaid and 4.4% in private plans annually. While the overall spending growth […]

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